Chronic Kidney Disease (CKD) Guideline Adherence - A Quality Improvement Study

Louis Stokes VA Medical Center

Status: Completed

Conditions: Chronic Renal Insufficiency

Treatments: Behavioral: Multifactorial intervention; Behavioral: Education only

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT00921687

LSCVAMCCKD1

Details and patient eligibility

About

Chronic kidney disease (CKD) is defined as kidney damage for greater than 3 months or a glomerular filtration rate less than 60 mL/min per 1.73m2 for greater than 3 months. Patients with CKD are at high risk for development of cardiovascular disease and metabolic complications. Guidelines for the care of patients with CKD have been developed by the National Kidney Foundation. Despite the wide availability of these guidelines, adherence is low. The goal of the current study is to evaluate whether a multifactorial intervention, including a CKD registry, will improve CKD guideline adherence. The hypothesis is that providers exposed to a multifactorial clinical intervention including education, academic detailing, and a CKD registry will be more likely to adhere to CKD guidelines than those only exposed to education.

Enrollment: 781 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Providers:

Inclusion Criteria:

• All primary care providers at the Wade Park Veterans Affairs Medical Center (VAMC) will be eligible for the study

Patients:

Inclusion Criteria:

• Receive primary care from a provider at the Wade Park VAMC

• Have:

  • CKD as defined by an estimated glomerular filtration rate (eGFR) less than 60 on two separate occasions 90 to 730 days apart,
  • diabetes, OR
  • hypertension

Exclusion Criteria:

• End-stage renal disease
• Renal transplant recipients
• Less than 18 years of age on July 1, 2009
• No primary care visit between Jan 1, 2008 and July 1, 2009

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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781 participants in 2 patient groups

Multifactorial intervention

Experimental group

Description:

The multifactorial intervention will consist of a CKD lecture, the CKD reference card, academic detailing, and access to the CKD registry.

Treatment:

Behavioral: Multifactorial intervention

Education only

Active Comparator group

Description:

Providers in the education only arm will receive a CKD lecture and be given a CKD reference card.

Treatment:

Behavioral: Education only